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A variety of strategies have demonstrated effectiveness in preventing or reducing ATOD use.Project Alert, described by Phyllis Ellickson and colleagues in a 1993 article, and Life Skills Training Program, described by Gill Botvin and colleagues in 1995, are the two most-prevalent effective classroom-based-curricula. ringwalt hiv/aids and its impact on adolescentsdenise dion hallforscarolyn tucker halpernbonita iritani sexual activity among teens and teen pregnancy trendssheila peters TABLE 1 sexually transmitted diseasesangela huang smoking and its effect on children's healthchristopher s. The cost of alcohol abuse to society is estimated to be 0 billion per year in health care, public safety, and social welfare expenditures. kirby Substance abuse is an international problem of epidemic proportions that has particularly devastating effects on youth because the early initiation of alcohol, tobacco, or other drug (ATOD) use within this population is linked to abuse and related problem behaviors among adults.It is known that even the most effective and comprehensive school-based strategies, and even those that reinforce their messages across multiple grade levels, are only slightly more effective than school-based programs that are generally discredited in the early twenty-first century. In the YRBS data, about 16 percent of high school students report having had sex with four or more partners; 48 percent of adolescent African-American males report four or more sexual partners.There has evolved a consensus among both practitioners and researchers that school-based programs, by themselves, are insufficient. 2000 Annual Summary: Effective Prevention Principles and Programs. "Implementing a Comprehensive Drug Abuse Prevention Strategy." In Increasing Prevention Effectiveness, ed. Forty-two percent of sexually active respondents did not use a condom at last intercourse.

A number of models and theories address the causes of adolescent ATOD use.

The most salient of these is the "Risk and Protective Factor" framework, which has identified a variety of psychosocial factors associated with ATOD use.

In the individual domain, substance use has been linked to values and beliefs about and attitudes toward substances, genetic susceptibility, early ATOD use, sensation seeking, and various psychological disorders including anti-social, aggressive, and other problem behaviors.

Such efforts should be part of a broad and comprehensive array of prevention approaches that integrate both supply and demand reduction strategies in the family and community, as well as the individual, domains. Science-Based Practices in Substance Abuse Prevention: A Guide. Rockville, MD: Center for Substance Abuse Prevention. The presence of other sexually transmitted infections (STIs) can also facilitate HIV transmission.

See also: Drug and Alcohol Abuse; Guidance and Counseling, School; Family Composition and Circumstance, subentry on Alcohol, Tobacco, and Other Drugs; Out-of-School Influences and Academic Success; Risk Behaviors, subentry on Smoking and Its Effect on Children's Health. Washington, DC: Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, Division of Knowledge Development and Evaluation. Adolescents and young adults are physiologically and behaviorally at higher risk for acquiring STIs.

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